1. Healthy Start Coalition of Jefferson, Madison & Taylor Counties, Inc. State of the Infant Taylor County 2014

2. Taylor County Birth Counts 247 babies born in 2013 (221 in 2012) –184 White (168 in 2012) –60 Black (47 in 2012) –3 Other (6 in 2012)

3. Population Estimates 2012

4. Infant Mortality – a volatile indicator No infant deaths 2013 Rolling three year averages 5.6 infant deaths per 1,000 2011-2013 FL is 6.2 From fourth worst (2010-2012) in state 9 babies rate = 12.3

5. Volatility explained

6. Fetal Death Rate Remains Steady 2 fetal deaths in 2013 Rolling three year average = 9.8 fetal deaths per 1,000 deliveries 2011-2013 FL is 7.2 (2010-2012) rate = 9.4 – average is 2 fetal deaths per year

7. Low Birth Weight Currently, fifth worst rate in the State of Florida (Madison is highest) 72 babies born below 2500g (5.5 lbs) Rate is 10.1 per 1,000 live births Moved down from fourth worst in state 2011-2012; 80 babies rate = 10.9 Why is this rate not improving?

8. Is it Obesity During Pregnancy ??

9. Is it smoking rates??

10. Is it Pregnancy Intervals? 35.9% of pregnancies in Taylor County are not adequately spaced

11. Is it the support system? 57.2% of births in Taylor County are to an unwed mother

12. Worth Mention 22.3% of adults over the age of 25 (2011) in Taylor County had NO high school diploma tied with Putnam Taylor area has second highest positive screening rate for Healthy Start 47% (Gadsden 56%, State is 24%)

13. Healthy Start Prenatal Screening 217 of 247 pregnant women responded (screened) 2012-2013 Results

14. More results

15. HS Screen is comprehensive

16. Final risk factors

17. Taylor Healthy Start Of the total births in Taylor County in FY 12/13, 82% were screened for Healthy Start (n=217) 71 were positive for risks for poor birth outcomes, another 44 were professionally referred 91 NEW pregnant women were reached by Healthy Start and funneled into care

18. More… A total of 169 pregnant women received a Healthy Start service in Taylor County 35 of these were high-risk 179 infants (ages 0-3) received a Healthy Start service; 26 were highest risk 9 infants/families received Parents as Teachers

19. Bad News Taylor County moving in wrong direction for rate of REPEAT births to teens ages 15-19 15 per 1,000 2011- 2013) up from 12.4 10-12 Breastfeeding rates for minorities- gap is widening Breastfeeding Initiation BlackWhite 2011-1345.9%70.3% 2010-1244.6%68.7% 2009-1145.1%67.2%

20. More good… Taylor County traditionally has high rates of EARLY entry into prenatal care -78.5% of pregnant women seek care in the first trimester (2011-13) Florida avg. is 80%, Wakulla is 86%

21. Root Causes Obesity contributing to preterm birth, low birth weight Access to care – Health Department is a SAFETY NET Health Literacy Perpetual Poverty Cyclical FASD

22. Fetal Alcohol Spectrum Disorder An underlying cause of poor school readiness rates An underlying cause of poor school performance An underlying cause of disproportionate rates of juvenile offenses, and subsequent D.O.C. involvement

23. Types of FASD Fetal Alcohol Syndrome (FAS): FAS represents the severe end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others. Alcohol-Related Neurodevelopmental Disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control. Alcohol-Related Birth Defects (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

24. Completely preventable

25. Why focus on minority health? Highlights of the Minority Health profile –Black infant death rate was 9.9, compared to 5.6 for whites (2011-13) –Fetal death rate was 33.5, compared to 5.5 for whites (2011-13) –Individuals below the poverty level 44.2% for blacks, 12.4% for whites (2006-10) –Births to unwed mothers 2:1 ratio (2010-12)

26. Why focus on minority health? -cont’d highlights –Births < 37weeks gestation 18.1% for blacks, compared to 10.1% for whites (2010-12) –Births to obese mothers 42.8%, compared to 24.6% for whites (2010-12) –Death rate for stroke 2.1:1 (10-12) –Death rate for congestive heart failure 2.3:1(10-12) –Incidence rate for prostrate cancer 2.3:1(08-10) –Death rate from diabetes 1.8:1 (10-12)

27. Food for thought

28. Solutions Whole Child Connection Medical Home Linkages for African American women Education to consumers on Medicaid Reform Advocate at state level for rural allocations Quality Programming Nutrition and Obesity prevention